Features of treatment, hospitalization and working ability of newly diagnosed patients with pulmonary arterial hypertension before and after diagnosis verification

Abstract

Objective. The aim of the study is to examine treatment patterns, hospitalizations, work disability and describe demographic and clinical characteristics of newly diagnosed patients with pulmonary arterial hypertension (PAH) before and after diagnosis verification in real clinical practice in Russia. Design and methods. Longitudinal prospective observational study with a retrospective part was conducted. Adult patients were included after PAH verification based on right heart catheterization. The data was received via patients interviewing and medical documentation analysis at enrollment and every 3 months. The retrospective design was used to collect information before enrollment. Results. Thirty-three patients with newly diagnosed PAH were enrolled in the study. Most patients had II (45,5 %) or III (36,4 %) WHO functional class. During follow-up period 2 patients died because of PAH complications, 1 patient died due to COVID-19 complications, and 1 patient was lost for follow-up. Before PAH verification 12,1 % of all patients did not work due to PAH symptoms while after verification of the diagnosis this proportion doubled. Diuretics and mineralocorticoid-receptor antagonists were the most frequently used drugs before PAH diagnosis confirmation, 9 % of patients took sildenafil. Most patients (64 %) received monotherapy as initial PAH-specific treatment, in 34 % of all patients treatment was escalated within 12 months after PAH verification. The number of hospitalizations significantly decreased after PAH verification and specific therapy prescription (р < 0,05). Conclusions. This study demonstrated a decrease in the number of hospitalizations after PAH verification, which may confirm the effectiveness of various regimens of PAH-specific therapy in real clinical practice in Russia. In addition, the study identified a number of problems associated with PAH (predominance of initial monotherapy, low vaccination coverage, problems with drug provision, etc.) The solution of these problems may improve the outcomes.